A 51-year-old right-hand-dominant farmer presented to the emergency department complaining of pain, swelling and restricted movements in his right index finger. The symptoms had been present for 2 days and were gradually increasing in severity. He did not report any trauma to the finger but had been working on his farm. He had no significant past medical history. On examination, he was apyrexial without lymphadenopathy. He had a fusiform swelling over the finger with some redness, and the finger was held in slight flexion at inter-phalangeal joints. He was tender over the volar aspect of the distal inter-phalangeal (DIP) joint and, to a lesser extent, over the rest of the finger as well. He had pain on passive extension of the finger. He could actively flex his finger at both inter-phalangeal joints with minimal discomfort. Clinical examination suggested the diagnosis of tendon sheath infection, but inflammatory markers showed a WBC count of 9,400/μl and CRP of 10 mg/l. AP and lateral radiographs showed calcification over the volar aspect of DIP joint near the flexor digitorum profundus (FDP) insertion (Fig. 1). A tentative diagnosis of an avulsion fracture of the base of distal phalanx was made, and therefore, antibiotics were withheld. The finger was splinted, and the patient was referred to the fracture clinic on a course of anti-inflammatory medication. Upon review in the fracture clinic after 5 days, it was noticed that the swelling and pain had subsided significantly, and he was only tender over the volar aspect of the DIP joint. No radiographs were taken at this stage. At his second followup visit 3 weeks later, he was found to be completely pain free, without swelling over the finger, and he had full range of movements at inter-phalangeal joints. Fresh radiograph taken on the day showed almost complete disappearance of the calcification (Fig. 2).